痰热清联合利巴韦林治疗小儿疱疹性咽峡炎的临床观察

目的:观察痰热清注射液联合利巴韦林注射液治疗小儿疱疹性咽峡炎的临床疗效.方法:将58例疱疹性咽峡炎患儿随机分为两组.观察组30例,应用痰热清注射液0.3 ～0.5 mL/(kg·d)联合利巴韦林注射液每次10～ 15 mg/kg静脉滴注,1次/d,疗程3～5d;对照组28例,单独应用利巴韦林注射液静脉滴注.两组对症治疗相同,合并细菌感染者加用抗生素治疗.结果:观察组总有效率93.33％高于对照组78.57％( P＜0.05),两组退热时间、恢复进食时间、疱疹消退时间、病程比较观察组均优与对照组(P＜0.01).结论:痰热清注射液联合利巴韦林注射液治疗小儿疱疹性咽峡炎疗效满意.     

莪术油葡萄糖注射液治疗小儿疱疹性咽峡炎

目的:评价中药莪术油葡萄糖注射液治疗小儿疱疹性咽峡炎的效果。方法:将124例疱疹性咽峡炎的患儿随机分为两组:治疗组62例,用莪术油葡萄糖注射液,按10mg·kg~(-1)·d~(-1),ivd,qd,疗程3～5d;对照组62例用利巴韦林注射液,按10～15mg·kg~(-1)·d~(-1),ivd,qd,疗程3～5d。观察发热、咽痛症状变化及咽部疱疹消退情况。结果:莪术油葡萄糖注射液治疗组退热时间、疱疹消退时间与对照组相比,经统计学处理差异有统计学意义,P<0.01。结论:莪术油葡萄糖注射液是治疗小儿疱疹性咽峡炎安全、有效的药物之一,值得临床应用。     

清开灵注射液治疗疱疹性咽峡炎30例临床观察

目的:观察清开灵注射液对疱疹性咽峡炎的临床疗效。方法:将患者随机分为两组,治疗组采用清开灵注射液1 mL·kg-1·d-1～2 mL·kg-1·d-1连用5d,对照组用利巴韦林注射液10 mL·kg-1·d-1～15 mL·kg-1·d-1静脉滴注,两组均静脉滴注青霉素。青霉素过敏2例换用头孢哌酮。观察两组体温恢复时间和疱疹消退时间。结果:治疗组体温恢复时间快,疱疹消失时间短,疗效优于对照组。结论:清开灵注射液较利巴韦林注射液在疱疹性咽峡炎体温恢复时间,疱疹消退时间,有明显优点。     

利巴韦林和甲氰咪胍雾化吸入治疗小儿疱疹性咽峡炎50例疗效观察

目的观察采用利巴韦林和甲氰咪胍雾化吸入治疗小儿疱疹性咽峡炎疗效。方法对照组45例给予常规治疗;治疗组50例在常规治疗基础上加用利巴韦林10～15mg/（kg.d）,及甲氰咪胍10～15mg/（kg.d）,雾化吸入治疗,2次/d。结果治疗组热退时间及疱疹消退时间明显少于对照组,疗程明显缩短。结论利巴韦林和甲氰咪胍雾化吸入治疗小儿疱疹性咽峡炎疗效显著,不良反应少。     

鱼腥草注射液雾化吸入治疗幼儿疱疹性咽峡炎84例疗效观察

目的:观察鱼腥草注射液雾化吸入治疗疱疹性咽峡炎的疗效。方法:将147例疱疹性咽峡炎患儿随机分为两组,治疗组84例,用利巴韦林10mg/(kg·d)静脉滴注及鱼腥草注射液2mL 生理盐水2mL氧气驱动雾化吸入,每日2次;对照组63例,予利巴韦林10mg/(kg·d)静脉滴注。两组对症治疗相同,考虑合并细菌感染者加口服抗生素。观察患儿治疗前后咽部疼痛、流涎等症状程度及溃疡数目。结果:治疗组总有效率比对照组总有效率明显提高,两组比较差异有显著性意义(P<0.05)。结论:加用鱼腥草注射液雾化吸入治疗小儿疱疹性咽峡炎有助于提高疗效、缩短病程、减少患儿痛苦。     

利巴韦林联合阿昔洛韦对疱疹性咽峡炎的临床疗效

目的 :探讨利巴韦林联合阿昔洛韦与单用利巴韦林对疱疹性咽峡炎的临床效果。方法 :6 2例疱疹性咽峡炎患儿随机分为治疗组 32例 ,采用利巴韦林 10～ 15mg/ (kg·d)分两次静滴 ,阿昔洛韦 15mg/ (kg·d)分 2～ 3次静滴 ;对照组 30例 ,采用利巴韦林治疗 ,剂量、用法同治疗组。两组均给予抗生素及相应对症治疗。结果 :治疗后平均退热天数、住院平均天数均显著较对照组短(P均 <0 0 1)。结论 :利巴韦林联合阿昔洛韦治疗疱疹性咽峡炎较单用利巴韦林效果更好。     

康复新液超声雾化吸入治疗小儿疱疹性咽峡炎76例疗效观察

目的观察康复新液超声雾化吸入治疗小儿疱疹性咽峡炎的疗效。方法将144例疱疹性咽峡炎患儿随机分为两组。治疗组76例采用利巴韦林10mg／（kg·d）静脉滴注及康复新液5mL超声雾化吸入,每日2次;对照组68例采用利巴韦林10mg／（kg·d）静脉滴注。两组对症治疗相同。观察患儿体温、咽痛流涎、疱疹及溃疡数目,对两组治疗效果进行比较。结果治疗组疗效优于对照组,两组比较差异有统计意义（P〈0．05）。治疗组发热、咽痛流涎、疱疹及溃疡消失时间也短于对照组（P〈0．01）。结论加用康复新液超声雾化吸入治疗小儿疱疹性咽峡炎有助于提高疗效,缩短病程,减轻患儿痛苦。应用中未发现明显不良反应,值得临床推广。     

葡萄糖酸锌颗粒辅助治疗儿童疱疹性咽峡炎疗效观察

目的:探讨葡萄糖酸锌颗粒辅助治疗儿童疱疹性咽峡炎的效果。方法:选取我院2014年4月至2015年5月收治的疱疹性咽峡炎患儿98例,采用随机数表分为对照组和观察组各49例。对照组行常规治疗:利巴韦林颗粒每天10~15 mg/kg,分3~4次服用;利巴韦林气雾剂喷雾吸入治疗,每4~5 h 1次,2揿/次;酌情给予物理降温、退热药物治疗、静脉营养支持等。观察组在常规治疗基础上加用葡萄糖酸锌颗粒10 mg/d,分2次服用。两组均持续用药5 d,观察患儿临床症状恢复时间、治疗效果及不良反应。结果:观察组治疗过程中未见明显不良反应,总有效率89.80%,高于对照组的73.47% (P<0.05);观察组退热时间、流涎消退时间、咽峡部疱疹消失时间、咽痛消失时间、恢复进食时间分别为(1.28±0.46)d、(2.11±0.69)d、(3.25±0.48)d、(2.41±0.63)d、(1.64±0.55)d,均短于对照组(P均<0.05);观察组治疗后CK-MB、CK水平分别为(13.63±3.85)U/L、(65.28±9.52)U/L,均低于对照组(P均<0.05)。结论:葡萄糖酸锌颗粒辅助治疗儿童疱疹性咽峡炎,可加快临床症状恢复,提高临床疗效。     

热毒宁注射液治疗疱疹性咽峡炎的疗效观察

目的观察热毒宁注射液治疗疱疹性咽峡炎的疗效及不良反应。方法将疱疹性咽峡炎患儿72例随机分为治疗组37例和对照组35例。治疗组给予热毒宁注射液静脉滴注,对照组给予利巴韦林注射液静脉滴注,疗程3～5d,并根据病情给予相应对症支持治疗。比较2组临床疗效和不良反应。结果治疗组总有效率为91.9%,高于对照组的71.4%,差异有统计学意义(P<0.05)。对照组出现疱疹破溃为溃疡5例,治疗组未见不良反应。结论热毒宁注射液治疗疱疹性咽峡炎疗效好、安全性高,值得临床推广。     

热毒宁注射液治疗儿童疱疹性咽峡炎的疗效及安全性

目的评价热毒宁注射液治疗儿童疱疹性咽峡炎的疗效及安全性。方法120例疱疹性咽峡炎患儿随机分为治疗组及对照组,每组各60例。在接受常规补液及对症治疗的基础上,治疗组采用热毒宁注射液0．6～0．8mL／kg加5％葡萄糖注射液100mL静脉滴注,一日1次;对照组采用利巴韦林注射液10mg／kg加5％葡萄糖注射液100mL静脉滴注,一日1次,疗程均为3～5d。观察患儿经治疗后的退热时间、疱疹消失时间及药物不良反应。结果治疗组平均退热时间及疱疹消失时间均短于对照组,且差异有统计学意义的显著性（P〈0．01）。治疗组显效率及总有效率分别为40．0％和91．7％,均高十对照组,且差异有统计学意义（P〈0．05）。两组均未观察到显著不良反应。结论热毒宁注射液治疗儿童疱疹性咽峡炎的疗效优于利巴书林注射液,且安全性较好。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.